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The feasibility and safety of pulsed field ablation for persistent atrial fibrillation: a prospective study
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  • Guocai Chen,
  • Mingyang Gao,
  • Yi-wei Lai,
  • Xing-Peng Liu,
  • Shijun Xia,
  • Song Zuo,
  • Xue-Yuan Guo,
  • Nian Liu,
  • Deyong Long,
  • Jian zeng Dong,
  • Liu He,
  • Xin Du,
  • Li Song-Nan,
  • Caihua Sang,
  • Chang Sheng Ma
Guocai Chen
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Mingyang Gao
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Yi-wei Lai
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Xing-Peng Liu
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Shijun Xia
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Song Zuo
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Xue-Yuan Guo
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Nian Liu
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Deyong Long
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Jian zeng Dong
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Liu He
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Xin Du
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Li Song-Nan
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Caihua Sang
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery
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Chang Sheng Ma
Capital Medical University Affiliated Anzhen Hospital Department of Vascular Surgery

Corresponding Author:chshma@vip.sina.com

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Abstract

Introduction: Pulsed field ablation (PFA) is a novel nonthermal ablation approach using rapid electrical pulses to cause cardiac cell apoptosis via electroporation. Our study aims to investigate the feasibility and safety of PFA for persistent atrial fibrillation (PeAF). Methods: 32 consecutive patients diagnosed with PeAF were enrolled in our study. All patients underwent PFA treatment using the strategy including pulmonary vein isolation (PVI), left atrial posterior wall (LAPW) isolation, cavotricuspid isthmus (CTI) block, and mitral isthmus (MI) block. Acute and follow-up procedure outcomes were evaluated, and adverse events related to the ablation procedure were also observed. Results: One-year survival free from atrial tachyarrhythmia post-ablation was 65.6%. Acute success rates for PVI, LAPW isolation, CTI block, and MI block were 100%, 100%, 96.9%, and 81.3%, respectively. Eleven cases (34.4%) experienced atrial tachyarrhythmia recurrence, with 8 cases being atrial fibrillation recurrence and 3 cases being atrial flutter recurrence. Three patients underwent repeat ablation. Minor complications were encountered in 4 patients with asymptomatic cerebral lesions. Vagal responses were commonly observed during the procedure. No severe coronary vasospasm or severe haemolysis occurred in our cohort. Conclusion: PFA with the strategy including PVI, LAPW isolation, CTI block, and MI block is feasible, safe, and associated with a high rate of freedom from atrial tachyarrhythmia recurrence at 1 year in patients with PeAF.